FISDAP Paramedic Final Exam Practice 2026/2027
Complete Practice Exam | Actual Questions & Verified
Answers | Trauma, Medical, Airway, Cardiology, OBGYN,
Operations | Pass Guarantee
TRAUMA (Questions 1–20)
1.
Dispatch: “MVC, highway speed, driver side intrusion, patient still in vehicle.”
Scene: 34-year-old male restrained driver. Steering-wheel deformity. Alert, pale,
diaphoretic.
Primary survey: Airway patent, RR 28 labored, SpO₂ 94 % on 15 L NRB.
Vitals: BP 88/60, HR 126, skin cool/mottled, FAST (+) LUQ.
Pelvis stable, left thigh swollen, no distal pulse.
Next MOST critical intervention?
A. Application of PASG
B. 2 L 0.9 % NS wide open
C. Tourniquet to left thigh
D. Rapid sequence intubation
Correct Answer: C
,Rationale: Pulseless thigh after high-energy collision = probable vascular injury &
life-threatening hemorrhage. Tourniquet first per PHTLS “life over limb.” PASG no longer
indicated, NS bolus small aliquots after hemorrhage control, airway is intact for now.
2.
Motorcycle vs tree at 45 mph. Helmet cracked. Patient combative, GCS 11 (E3 V3 M5).
BP 170/90, HR 50 & irregular, RR 8, SpO₂ 88 % room air.
Right pupil 6 mm, left 3 mm.
Best immediate action?
A. Hyperventilate to 30 breaths/min
B. Insert King LT, assist at 10 breaths/min
C. Apply rigid collar, backboard, 250 mL 3 % hypertonic saline
D. Midazolam 5 mg IV to facilitate oxygenation
Correct Answer: B
Rationale: GCS ≤8 traditionally intubated; current AHA/ACS guidelines accept airway
adjunct if RSI not immediately available. Hypoventilation (RR 8) is killing the
patient—oxygenate first. Hyperventilation only if herniation signs AFTER oxygenation.
Midazolam drops BP. Hypertonic saline not first-line.
3.
Fall from 14 ft. Alert, BP 90/70, HR 120, RR 24.
,Left 6th–8th ribs tender, seat-belt bruise across upper abdomen.
FAST (+) splenorenal.
Most appropriate fluid strategy?
A. 2 L NS bolus then titrate to SBP >110
B. 250 mL NS boluses to maintain radial pulse
C. Permissive hypotension—no fluids until SBP <70
D. 1 unit PRBC field transfusion
Correct Answer: B
Rationale: PHTLS “balanced resuscitation”: small boluses (250 mL) to maintain palpable
radial pulse (~90 mmHg) avoids clot disruption. Permissive hypotension <70 risks
coronary hypoperfusion. Field blood rarely available in first 30 min.
4.
Adult male, flame burns in garage fire. Blisters face/chest/both arms.
Singed nasal hairs, carbonaceous sputum.
BP 130/80, HR 110, RR 26.
Using Rule of Nines estimate %TBSA?
A. 18 %
B. 27 %
C. 36 %
, D. 45 %
Correct Answer: C
Rationale: Head 9 %, anterior trunk 18 %, both arms 9 % each = 36 %. Face is part of
head; anterior chest 9 %, abdomen 9 %. Classic exam trap—don’t double count.
5.
Penetrating trauma to right neck zone II.
Active arterial bleeding controlled with direct pressure.
Patient hoarse, minor air leak from wound.
BP 100/70, HR 110, SpO₂ 93 %, GCS 15.
Next step?
A. Apply occlusive dressing, prepare for cricothyrotomy
B. Needle decompression right chest
C. Immediate OR alert—no airway manipulation
D. Blind finger sweep to explore tract
Correct Answer: A
Rationale: Neck penetration + hoarseness = airway injury. Occlusive dressing prevents
air embolism; cric kit ready because orotracheal intubation may worsen laceration.
Needle not indicated (no tension physiology).
6.
Complete Practice Exam | Actual Questions & Verified
Answers | Trauma, Medical, Airway, Cardiology, OBGYN,
Operations | Pass Guarantee
TRAUMA (Questions 1–20)
1.
Dispatch: “MVC, highway speed, driver side intrusion, patient still in vehicle.”
Scene: 34-year-old male restrained driver. Steering-wheel deformity. Alert, pale,
diaphoretic.
Primary survey: Airway patent, RR 28 labored, SpO₂ 94 % on 15 L NRB.
Vitals: BP 88/60, HR 126, skin cool/mottled, FAST (+) LUQ.
Pelvis stable, left thigh swollen, no distal pulse.
Next MOST critical intervention?
A. Application of PASG
B. 2 L 0.9 % NS wide open
C. Tourniquet to left thigh
D. Rapid sequence intubation
Correct Answer: C
,Rationale: Pulseless thigh after high-energy collision = probable vascular injury &
life-threatening hemorrhage. Tourniquet first per PHTLS “life over limb.” PASG no longer
indicated, NS bolus small aliquots after hemorrhage control, airway is intact for now.
2.
Motorcycle vs tree at 45 mph. Helmet cracked. Patient combative, GCS 11 (E3 V3 M5).
BP 170/90, HR 50 & irregular, RR 8, SpO₂ 88 % room air.
Right pupil 6 mm, left 3 mm.
Best immediate action?
A. Hyperventilate to 30 breaths/min
B. Insert King LT, assist at 10 breaths/min
C. Apply rigid collar, backboard, 250 mL 3 % hypertonic saline
D. Midazolam 5 mg IV to facilitate oxygenation
Correct Answer: B
Rationale: GCS ≤8 traditionally intubated; current AHA/ACS guidelines accept airway
adjunct if RSI not immediately available. Hypoventilation (RR 8) is killing the
patient—oxygenate first. Hyperventilation only if herniation signs AFTER oxygenation.
Midazolam drops BP. Hypertonic saline not first-line.
3.
Fall from 14 ft. Alert, BP 90/70, HR 120, RR 24.
,Left 6th–8th ribs tender, seat-belt bruise across upper abdomen.
FAST (+) splenorenal.
Most appropriate fluid strategy?
A. 2 L NS bolus then titrate to SBP >110
B. 250 mL NS boluses to maintain radial pulse
C. Permissive hypotension—no fluids until SBP <70
D. 1 unit PRBC field transfusion
Correct Answer: B
Rationale: PHTLS “balanced resuscitation”: small boluses (250 mL) to maintain palpable
radial pulse (~90 mmHg) avoids clot disruption. Permissive hypotension <70 risks
coronary hypoperfusion. Field blood rarely available in first 30 min.
4.
Adult male, flame burns in garage fire. Blisters face/chest/both arms.
Singed nasal hairs, carbonaceous sputum.
BP 130/80, HR 110, RR 26.
Using Rule of Nines estimate %TBSA?
A. 18 %
B. 27 %
C. 36 %
, D. 45 %
Correct Answer: C
Rationale: Head 9 %, anterior trunk 18 %, both arms 9 % each = 36 %. Face is part of
head; anterior chest 9 %, abdomen 9 %. Classic exam trap—don’t double count.
5.
Penetrating trauma to right neck zone II.
Active arterial bleeding controlled with direct pressure.
Patient hoarse, minor air leak from wound.
BP 100/70, HR 110, SpO₂ 93 %, GCS 15.
Next step?
A. Apply occlusive dressing, prepare for cricothyrotomy
B. Needle decompression right chest
C. Immediate OR alert—no airway manipulation
D. Blind finger sweep to explore tract
Correct Answer: A
Rationale: Neck penetration + hoarseness = airway injury. Occlusive dressing prevents
air embolism; cric kit ready because orotracheal intubation may worsen laceration.
Needle not indicated (no tension physiology).
6.
